| Summit View Medical, L. L. C. | |
|
9829 S 1300 E Suite 302 Sandy UT 84094-4000 | |
| (801) 576-8988 | |
| (801) 576-9396 |
| Full Name | Summit View Medical, L. L. C. |
|---|---|
| Speciality | Family Medicine |
| Location | 9829 S 1300 E, Sandy, Utah |
| Authorized Official Name and Position | Vernon D. Potter (MANAGING MEMBER) |
| Authorized Official Contact | 8015768988 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Summit View Medical, L. L. C. 9829 S 1300 E Suite 101 Sandy UT 84094-4000 Ph: (801) 576-8988 | Summit View Medical, L. L. C. 9829 S 1300 E Suite 302 Sandy UT 84094-4000 Ph: (801) 576-8988 |
| NPI Number | 1295876639 |
|---|---|
| Provider Enumeration Date | 02/09/2007 |
| Last Update Date | 08/31/2012 |
| Medicare PECOS PAC ID | 8729128764 |
|---|---|
| Medicare Enrollment ID | O20091222000606 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295876639 | NPI | - | NPPES |
| 394660823016 | Medicaid | UT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 2939081205 (Utah) | Primary |
| Provider Name | Vernon D Potter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801937263 PECOS PAC ID: 5092855031 Enrollment ID: I20091222000603 |
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